Rhegmatogenous retinal detachment in gyrate atrophy: a case report and review of literature

We present a rare case of a 25-year-old Polish male diagnosed with rhegmatogenous retinal detachment (RRD) on a background of gyrate atrophy (GA), successfully treated with pars plana vitrectomy (PPV) combined with cryotherapy and perfluoropropane (C3F8) gas tamponade.

Regular ophthalmic examinations with optical coherence tomography were performed preoperatively and three months postoperatively.

The patient initially presented with acute loss of vision to counting fingers in the left eye secondary to a macula-off RRD. Intraoperatively, multiple circumferential skirts of vitreous bands and a peripheral break at 11 o'clock were identified. The break was treated with cryotherapy and C3F8 gas tamponade. The patient underwent left-sided cataract surgery six months following his vitrectomy and subsequently a YAG laser posterior capsulotomy. The retina remained attached at his 9-month follow up with a final best-corrected visual acuity of 6/9-1.

PPV with cryotherapy and perfluoropropane tamponade can be an effective surgical approach in the management of RRD with underlying GA. Compared to previously reported cases, a favourable visual outcome was achieved in our case, likely attributed to the absence of other ophthalmic complications (such as proliferative vitreoretinopathy) and timely surgical intervention. Recognising atypical vitreous characteristics intraoperatively may refine surgical techniques and outcomes in similar cases. Future cases could consider an encircling scleral band for additional support, particularly in cases involving inferior retinal breaks.